Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.930
Filtrar
6.
J Emerg Manag ; 18(7): 31-35, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33351183

RESUMO

INTRODUCTION: Local and regional policies to guide the allocation of scarce critical care resources have been developed, but the views of prospective users are not understood. We sought to investigate the perspectives of Canadian acute care physicians toward triaging scarce critical care resources in the COVID-19 pandemic. METHODS: We rapidly deployed a brief survey to Canadian emergency and critical care physicians in April 2020 to investigate current attitudes toward triaging scarce critical care resources and identify subsequent areas for improvement. Descriptive and between-group analyses along with thematic coding were used. RESULTS: The survey was completed by 261 acute care physicians. Feelings of anxiety related to the pandemic were common (65 percent), as well as fears of psychological distress if required to triage scarce resources (77 percent). Only 49 percent of respondents felt confident in making resource allocation decisions. Both critical care and emergency physicians favored multidisciplinary teams over single physicians to allocate scarce critical care resources. Critical care physicians were supportive of decision making by teams not involved in patient care (3.4/5 versus 2.9/5 p = 0.04), whereas emergency physicians preferred to maintain their involvement in such decisions (3.4/5 versus 4.0/5 p = 0.007). Free text responses identified five themes for subsequent action including the need for further guidance on existing triage policies, ethical support in decision making, medicolegal protection, additional tools for therapeutic communications, and healthcare provider psychological support. CONCLUSION: There is an urgent need for collaboration between policymakers and frontline physicians to develop critical care resource triage policies that wholly consider the diversity of provider perspectives across practice environments.


Assuntos
Medicina de Emergência , Médicos , Canadá , Cuidados Críticos , Humanos , Pandemias , Estudos Prospectivos , Triagem
7.
J Spec Oper Med ; 20(4): 73-76, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320316

RESUMO

The Portland, Oregon, Bureau of Fire & Rescue (PF&R) established a tactical emergency medical support team embedded within the Police Bureau's Rapid Response Team (RRT). The authors describe the team's training and their recent work.


Assuntos
Serviços Médicos de Emergência , Medicina de Emergência , Tumultos , Emergências , Humanos , Polícia
8.
Stud Health Technol Inform ; 275: 187-191, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33227766

RESUMO

This paper presents the early outcomes of the educational cooperation between two European academic associations, namely the European Federation of Medical Informatics (EFMI) and European Society of Emergency Medicine (EUSEM). Two webinars were organized in December 2019 and June 2020 to explore areas where mutual education would be beneficial for interdisciplinary cooperation to advance the digitization of emergency departments for the benefit of patients, health professionals and the health system as a whole. Preliminary findings from the analysis of these two webinars are presented and the steps for further cooperation are outlined.


Assuntos
Medicina de Emergência , Informática Médica , Humanos , Estudos Interdisciplinares , Organizações , Sociedades
9.
BMC Med Educ ; 20(1): 348, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028295

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has engendered difficulties for health systems globally; however, the effect of the pandemic on emergency medicine (EM) residency training programs is unknown. The pandemic has caused reduced volumes of emergency department (ED) patients, except for those with COVID-19 infections, and this may reduce the case exposure of EM residents. The primary objective of this study was to compare the clinical exposure of EM residents between the prepandemic and pandemic periods. METHODS: This was a retrospective study of EM resident physicians' training in a tertiary teaching hospital with two branch regional hospitals in Taiwan. We retrieved data regarding patients seen by EM residents in the ED between September 1, 2019, and April 30, 2020. The first confirmed COVID-19 case in Taiwan was reported on January 11, so the pandemic period in our study was defined as spanning from February 1, 2020, to April 30, 2020. The number and characteristics of patients seen by residents were recorded. We compared the data between the prepandemic and pandemic periods. RESULTS: The mean number of patients per hour (PPH) seen by EM residents in the adult ED decreased in all three hospitals during the pandemic. The average PPH of critical area of medical ED was 1.68 in the pre-epidemic period and decreased to 1.33 in the epidemic period (p value < 0.001). The average number of patients managed by residents decreased from 1.24 to 0.82 in the trauma ED (p value = 0.01) and 1.56 to 0.51 in the pediatric ED (p value = 0.003) during the pandemic, respectively. The severity of patient illness did not change significantly between the periods. CONCLUSIONS: The COVID-19 pandemic engendered a reduced ED volume and decreased EM residents' clinical exposure. All portion of EM residency training were affected by the pandemic, with pediatric EM being the most affected. The patient volume reduction may persist and in turn reduce patients' case exposure until the pandemic subsides. Adjustment of the training programs may be necessary and ancillary methods of learning should be used to ensure adequate EM residency training.


Assuntos
Infecções por Coronavirus/epidemiologia , Medicina de Emergência/educação , Internato e Residência , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Idoso , Betacoronavirus , Serviço Hospitalar de Emergência/estatística & dados numéricos , Utilização de Instalações e Serviços , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taiwan
11.
Emerg Med J ; 37(12): 773-777, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33127743

RESUMO

BACKGROUND: Public health mitigation strategies in British Columbia during the pandemic included stay-at-home orders and closure of non-essential services. While most primary physicians' offices were closed, hospitals prepared for a pandemic surge and emergency departments (EDs) stayed open to provide care for urgent needs. We sought to determine whether ED paediatric presentations prior and during the COVID-19 pandemic changed and review acuity compared with seasonal adjusted prior year. METHODS: We analysed records from 18 EDs in British Columbia, Canada, serving 60% of the population. We included children 0-16 years old and excluded those with no recorded acuity or discharge disposition and those left without being seen by a physician. We compared prepandemic (before the first COVID-19 case), early pandemic (after first COVID-19 case) and peak pandemic (during public health emergency) periods as well as a similar time from the previous year. RESULTS: A reduction of 57% and 70% in overall visits was recorded in the children's hospital ED and the general hospitals EDs, respectively. Average daily visits declined significantly during the peak-pandemic period (167.44±40.72) compared with prepandemic period (543.53±58.8). Admission rates increased mainly due to the decrease in the rate of visits with lower acuity. Children with complaints of 'fever' and 'gastrointestinal' symptoms had both the largest overall volume and per cent reduction in visits between peak-pandemic and prior year (79% and 74%, respectively). CONCLUSION: Paediatric emergency medicine attendances were reduced to one-third of normal numbers during the 2020 COVID-19 lockdown in British Columbia, Canada, with the reduction mainly seen in minor illnesses that do not usually require admission.


Assuntos
Infecções por Coronavirus/epidemiologia , Medicina de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Hospitais Pediátricos/organização & administração , Pneumonia Viral/epidemiologia , Adolescente , Betacoronavirus/patogenicidade , Colúmbia Britânica/epidemiologia , Criança , Pré-Escolar , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Emergências/epidemiologia , Medicina de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pandemias/prevenção & controle , Admissão do Paciente/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Triagem/organização & administração , Triagem/estatística & dados numéricos
12.
Med Klin Intensivmed Notfmed ; 115(8): 625-632, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33044657

RESUMO

Emergency medicine and intensive care medicine have many similarities. In this review, we will first discuss the terminology of emergency medicine in a hospital in terms of a uniform designation as a department for emergency medicine or emergency department. Emergency medicine and intensive care medicine are a location-independent concept of patient care in the sense of the recognition, treatment and diagnosis of acute health disorders. Emergency medicine covers the entire range of disease severity, while intensive care medicine focuses on organ replacement and organ preservation, uses highly specialized technology for this purpose and treats only the seriously ill. The treatment of seriously ill patients in the emergency departments requires special intensive care medical knowledge both by the physicians and nursing staff. In the medical field, the curriculum for the European emergency medicine specialist takes into account all aspects necessary for the diagnosis and treatment of critically ill patients. For the nursing sector, Germany has had its own recognized specialty training program in emergency medicine for several years. However, the treatment of critically ill patients in emergency departments also requires that the emergency departments be adequately equipped. In this regard, there is an urgent need for statutory quality criteria that are concrete and structured. We know from the literature that intensive care competence in emergency departments reduces the admission rate to intensive care units and the mortality of all emergency patients. The concept of intensive care units in the emergency department is gaining popularity in the USA and should also be evaluated for implementation in the German-speaking countries.


Assuntos
Medicina de Emergência , Cuidados Críticos , Serviço Hospitalar de Emergência , Alemanha , Humanos , Unidades de Terapia Intensiva
13.
West J Emerg Med ; 21(6): 83-87, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-33052816

RESUMO

INTRODUCTION: We are currently in the midst of the coronavirus disease 2019 (COVID-19) pandemic. Research into previous infectious disease outbreaks has shown that healthcare workers are at increased risk for burnout during these dire times, with those on the front lines at greatest risk. The purpose of this prospective study was to determine the effect that the COVID-19 pandemic has had on the wellness of emergency physicians (EP). METHODS: A survey was sent to 137 EPs in a multi-hospital network in eastern Pennsylvania. We compared 10 primary and two supplemental questions based on how the physicians had been feeling in the prior 2-3 weeks (COVID-19 period) to the same questions based on how they were feeling in the prior 4-6 months (pre-COVID-19 period). RESULTS: We received 55 responses to the survey (40.1% response rate). The study found that during the pandemic, EPs felt less in control (p-value = 0.001); felt decreased happiness while at work (p-value 0.001); had more trouble falling asleep (p-value = 0.001); had an increased sense of dread when thinking of work needing to be done (p-value = 0.04); felt more stress on days not at work (p-value <0.0001); and were more concerned about their own health (p-value <0.0001) and the health of their families and loved ones (p-value <0.0001). CONCLUSION: This study showed a statistically significant decrease in EP wellness during the COVID-19 pandemic when compared to the pre-pandemic period. We need to be aware of evidence-based recommendations to help mitigate the risks and prevent physician burnout.


Assuntos
Esgotamento Profissional/prevenção & controle , Infecções por Coronavirus/epidemiologia , Saúde do Trabalhador , Estresse Ocupacional/epidemiologia , Médicos/psicologia , Pneumonia Viral/epidemiologia , Adulto , Esgotamento Profissional/epidemiologia , Infecções por Coronavirus/prevenção & controle , Medicina de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pennsylvania , Pneumonia Viral/prevenção & controle , Estudos Prospectivos , Inquéritos e Questionários
16.
Acad Med ; 95(10): 1465-1466, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33002900
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA